Individual
MICAH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 36TH AVE NW STE 100, NORMAN, OK 73072-3251
(405) 253-0071
Mailing address
2240 36TH AVE NW STE 100, NORMAN, OK 73072-3251
(405) 253-0071
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106S00000X
NOT REQUIRED
—
Enumeration date
12/18/2019
Last updated
12/18/2019
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